A hip fracture is sustained by 250,000 Americans every year. The most common complication associated with hip fracture is delirium.
Delirium is a serious medical condition that consists of a disturbance of consciousness with a reduced ability to focus, sustain, or shift attention.
Multiple studies have shown that patients with postoperative delirium are less likely to return to their preinjury level of function, are more frequently placed in nursing homes, and ultimately have an increased rate of mortality.
Delirium can be completely prevented in up to one-third of at-risk patients. When delirium cannot be prevented, the prevalence of severe delirium can be reduced by up to 50%.
Optimal treatment of delirium requires excellent teamwork among the orthopaedic surgeon, anesthesiologist, internist or geriatrician, and others.
A hip fracture is sustained by 250,000 Americans every year1, and that number is expected to double by 20402. The most frequent complication associated with hip fracture in elderly patients is postoperative delirium3, with a prevalence ranging between 5% and 61%, depending on the patient population1,3-8. Delirium is often undetected, misdiagnosed, or undertreated9-11. However, this condition has severe consequences for the patient4,5,11. The focus of this article is to provide an overview of current knowledge regarding the outcomes, pathogenesis, diagnosis, prevention, and treatment of postoperative delirium in elderly patients treated for a hip fracture.
For the purposes of this article, delirium and acute confusional states are synonymous. Delirium consists of a “disturbance of consciousness.... with reduced ability to focus, sustain, or shift attention.” There is also “a change in cognition... or the development of a perceptual disturbance that is not better accounted for by a preexisting, established, or evolving dementia.”12 The diagnostic criteria …
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